Outline

Introduction

Pain management of coxarthrosis can be improved by assessing its trends and problems.

Method

A total of 406 patients with coxarthrosis-related hip arthroplasty in 1990-93 (n=205) and 2002-03 (n=201) were analysed for the duration of coxarthrosis, pharmacotherapy and conditions associated with a higher risk of adverse effects during a nonsteroidal anti-inflammatory therapy (NSAIDs and coxibs).

Results

The majority (1990-93: 73%, 2002-03: 79%) underwent total hip replacement within five years after onset of osteoarthritis related problems. Half of the patients received painkillers. NSAIDs predominated although 75% of the patients in both groups were at risk for gastric and/or renal adverse

effects. Almost every second risk patient in 1990-93 and 2002-03 received an NSAID (including coxibs). In contrast to 1990-93 NSAIDs were prescribed in combination with gastric protective medication in the time period 2002-03. Out of all prescribed NSAIDs in 2002-03, 20% were selective COX-II-inhibitors. There was an increase (+9%) of opioid medication in the latter period.

Discussion

Despite a substantial risk of adverse effects and interactions, which often goes unnoticed, the use of NSAIDs is widespread. Opioid analgetics are increasingly prescribed with a positive effect on osteoarthritis related pain and with a favourable safety profile. The aim is a patient-orientated pain